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FORM NO.16
[See rule 31(1)(a)]
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source on Salary
TDS Certificate
Financial year
number#
Whether Original / Duplicate / If Amended give Previous TDS
Amended Certificate number
Name of
TAN of Deductor
Deductor
Name of
PAN of Deductee
Deductee
Whether PAN
TDS Unique Transaction Number uploaded was
Gross Amount
(UTN) as provided by Income Tax validated by Income TDS/TCS Amount
Paid / Collected
Department Tax Department?
(Y/N)

Gross amount of TDS / TCS

Total TDS amount where PAN was found valid by Income Tax
Department*
Details of Salary paid and any other income and tax deducted

1 Gross Salary
Salary as per provisions contained in
(a) Rs
sec.17(1)
Value of perquisites u/s 17(2) (as per Form
(b) Rs
No.12BB, wherever applicable)
Profits in lieu of salary under section 17(3)(as
(c) Rs
per Form No.12BB, wherever applicable)
(d) Total Rs
2 Less: Allowance to the extent exempt u/s 10 Rs

Rs

Rs Rs

3 Balance(1-2) Rs

4 Deductions :

(a) Standard deduction Rs.

(b) Entertainment allowance Rs.

(c) Tax on employment Rs.

5 Aggregate of 4(a) to (c) Rs

6 Income chargeable under the head 'salaries' (3-5) Rs

7 Add: Any other income reported by the employee Rs

Rs

Rs Rs

8 Gross total income (6+7) Rs

9 Deductions under Chapter VIA

Qualifying Deductible
Gross Amount
Amount Amount
(a) Rs Rs Rs

(b) Rs Rs Rs

(c) Rs Rs Rs

(d) Rs Rs Rs Rs
Aggregate of deductible amount under
10 Rs
Chapter VIA
11 Total Income (8-10) Rs

12 Tax on total income Rs

13 Rebate and relief under Chapter VIII

I. Under section 88 (please specify)

Qualifying Tax rebate/
Gross Amount
Amount relief
(a) Rs Rs

(b) Rs Rs

(c) Rs Rs

(d) Rs Rs

(e) Rs Rs
(f) Total
Rs Rs
[(a) to (e)]
II (a) Under section 88B Rs

(b) Under section 88C Rs

III Under section 89 (attach details) Rs

Aggregate of tax rebates and relief at 13
14 Rs
above [I(f) + II(a)+ II(b) + III]
15 Tax payable (12-14) and surcharge thereon Rs

16 Less: Tax deducted at source Rs

17 Tax payable/refundable (15-16) Rs

I _____________________________________, son/daughter of _________________________________ working in
the capacity of ________________________________________ (designation) do hereby certify that a sum of
Rs. ____________________________ [Rupees ____________________________________________
_____________________________________________________________________________ (in words)] has been
deducted at source and paid to the credit of the Central Government. I further certify that the
information given above is true and correct based on the books of accounts, documents and other
available records.
Place

Date Signature of person responsible for deduction of tax

Designation Full Name